1. Field of the Invention
This invention pertains generally to computer-aided imaging systems and computer-aided radiological information systems. More specifically, the present invention incorporates image analysis and work order evaluation to ensure that a radiological information system and computer-aided imaging system produce desired and matched images and work orders in an automated and reliable manner.
2. Description of the Related Art
Radiological information systems provide a hospital, imaging or other medical facility appropriate computer software tools to manage information regarding radiological exams. Modern radiological imaging facilities will typically utilize a variety of highly sophisticated testing, imaging and analysis equipment. For exemplary purposes only, and not limited thereto, exemplary imaging equipment commonly found at such facilities may include CT, SPECT, PET, and MRI scanners. These machines are very expensive assets that will most desirably be operated in an efficient manner to minimize idle time and, simultaneously, to minimize the amount of time required to produce a desired set of images for a given patient. By minimizing the time required for a patient, the throughput on a given machine may be increased, decreasing the total cost per patient and reducing the need for additional machines that might be otherwise required to maintain a particular level of service. The patients will also see better service through reduced waiting time and fewer retakes or extra visits for missed or overlooked image requests.
The operations which are provided for through the radiological information system will typically include scheduling, billing, tracking, generation of work orders, storage of reference information such as referring physician, patient information, and the like. Such systems form an important accounting and management role within a well-managed facility and so are a vital part of the administrative data management.
In addition to the administrative scheduling and accounting functions of a typical radiological information system, additional management is required when receiving, handling and archiving radiological images. In particular, recent imaging systems are capable of generating either single images or, alternatively, a relatively large number of relatively small image slices. These slices may not be evenly distributed across a patient's body, but in accord with a physicians' needs may be unevenly concentrated in a particular body area or region. For exemplary purposes, multi-slice CT equipment is capable of producing hundreds of slices in a single very short scanning session, and the equipment is capable of scanning from the top of a person's head through the pelvis in a single acquisition. Multiple separate procedures or anatomical studies may be included in a single CT acquisition. The maintenance of this image data, which generally involves the archiving of large amounts of data, is most preferably handled through specialized computer systems referred to herein as Picture Archive and Communication Systems (PACS). A PACS system will most desirably incorporate much specialized software which enables specialized handling and display of the images, and will most preferably work cooperatively as a part of or in close association with the radiological information system.
Unfortunately, the objectives of the various systems are somewhat different from each other, and, as a result, certain technical challenges are present in the integration of the various components that comprise a complete radiological program. For example, to facilitate billing most radiological information systems require a specific work order be associated with each image set. That way, there is a clear accounting trail of work ordered and delivered, and the system can thereby ensure that the orders have properly been fulfilled and billed. This approach works very well for single study work orders. The work order may be generated without intelligent intervention, and the radiology technician can conduct the single study as ordered. When complete, the radiologist will generate a single radiology report and the facility will then deliver and bill for the study.
Unfortunately, when there is a multi-anatomical study or multi-procedure study work order placed, which is very well handled by many axial medical imaging scanners, neither the PACS system nor the radiological information system are well suited. Prior to the present invention, the persons entering or tracking the information would be called upon to recognize that the request was for a plurality of studies. In order for the radiological information system and the PACS to accurately account for this multi-study, a person would have to enter the work order manually by dividing the work order into a plurality of work orders. When the work order was not divided and manually entered, only one imaging study could be assigned to or electronically associated with the work order. Not only is a radiological information system designed to account for each study separately, but the PACS associates only one procedure with the study. Consequently, for a multi-anatomical study, the remaining image studies could not be assigned by the reading radiologist, and these studies remained unassigned and not associated with any particular work order. As a result, the facility was unable to properly account, track and bill for the remaining image studies.
As aforementioned, the prior art manual intervention is not limited solely to the entry of information into the radiological information system. Once the multi-study is properly entered into the radiological information system, including dividing into each individual study, the work order is conveyed to a technician responsible for conducting a particular study. In the case of a multi-anatomical study, such as for exemplary purposes only and not limiting thereto, a CT scan covering head, neck and upper torso, the CT technician will most desirably recognize that the patient can be positioned for a single comprehensive procedure. The work orders, however, indicate three separate procedures, a discrepancy that may, particularly in the case of a new or less-experienced technician, lead to error, confusion or delay, any of which is associated with a decreased level of service and the potential need to expose the patient multiple times to the imaging radiant energy.
When the CT technician properly completes the single comprehensive procedure, yet another problem exists. The work order has multiple studies specified, and yet there is only a single imaging sequence produced by the imaging equipment. Consequently, interpretation and manual intervention are once again required. This time, the technician must review the images and determine an appropriate grouping to correspond to the work order, or a radiologist or the like will otherwise have to re-organize the single multi-study output from the equipment to attempt to match the studies to the multiple work orders. In either case, additional work not associated directly with patient care is undesirably required.
In the event the multi-study imaging output is not divided (which is tedious work not directly affiliated with patient care) issues arise regarding the accounting between the radiology report and the radiological information system. When work orders are properly divided, but the images are not, the remaining work orders are all too frequently orphaned, unmatched to any image set in spite of the fact that the imaging study has actually been completed.
In either case, when work orders are not properly divided or images are not properly divided, another very significant benefit of the PACS is lost. By electronically archiving imaging information, a radiologist or other health care provider may compare present images to past images stored with the patient's records, and do this with almost no delay. Unfortunately, when either the work order or the imaging studies have not been properly manually divided, the physician will find it difficult or impossible to locate the archived images to carry out the past and present comparisons. For example, if the patient had a full scan including head, neck and upper torso as described above, and the results of the head scan were not stored with the head scan work order, the physician may be unable to locate the head scan, and may typically assume that it has been permanently lost or destroyed or waste valuable time researching what should be an automatic display. Many PACS systems refer to studies by procedure type, so it is important that distinct procedures be subdivided, or the information from the procedure may not be retrievable using the procedure type reference. As may be understood, comparisons of current imaging information with previous imaging data can be invaluable in the evaluation and diagnosis of a medical condition, and the loss of such useful information can be very detrimental to the provision of timely and efficient patient care.
What is desired then is a system which eliminates the tedious and unreliable manual intervention, and thereby allows the users of each system to better focus their efforts on their primary duties.